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Foster Care

Foster care


Foster care is full-time substitute care of children outside their own home by people other than their biological or adoptive parents or legal guardians.


Children who are removed from their biological or adoptive parents, or other legal guardians, are placed in foster care in a variety of settings. They may be placed in the care of relatives other than the family members involved in the neglect or abuse (kin placement), non-relatives, therapeutic or treatment foster care, or in an institution or group home.

Children come to foster care for a number of reasons. In many cases, they have suffered physical or sexual abuse, or neglect at home, and are placed in a safe environment. A small percentage of children are in foster care because their parents feel unable to control them, and their behavior may have led to delinquency or fear of harm to others. Some children have been neglected by their parents or legal guardians, or have parents or legal guardians who are unable to take care of them because of substance abuse, incarceration, or mental health problems. These children are placed into custodial care while the parents or guardians receive treatment or counseling, or fulfill their sentences.

In all foster care cases, the child's biological or adoptive parents, or other legal guardians, temporarily give up legal custody of the child. (The guardian gives up custody, but not necessarily legal guardianship.) A child may be placed in foster care with the parents' consent. In a clear case of abuse or neglect, a court can order a child into foster care without the parents' or guardians' consent. Foster care does not necessarily mean care by strangers. If a government agency decides a child must be removed from the home, the child may be placed with relatives or with a family friend. Children may also be placed in a group home, where several foster children live together with a staff of caregivers. Therapeutic or treatment foster care can be in a group home or foster home with a specific structure and treatment focus. Foster homes are the most well-known option. The child temporarily becomes a part of another family, either with other foster children, the family's biological or adoptive children, or alone. State or county social service agencies oversee foster care decisions, although they may also work with private foundations.

Foster parents must be licensed by the agency that handles a specific region's foster care. The foster home must pass an inspection for health and safety and, in most states, the parents must attend training sessions covering issues of x how to deal with problems. When a child is placed, the foster family takes responsibility for feeding and clothing the child, getting the child to school and to appointments, and doing any of the usual things a child's parents or legal guardians might be called to do. The foster parents might also need to meet with the foster child's therapist and will meet regularly with the child's caseworker as well. The foster parent aims to help the foster child develop normally in a safe, family environment.

Foster parents usually receive money for taking in foster children. They are expected to use the money to buy the child's food, clothing, school supplies, and other incidentals. Most of the foster parent's responsibilities toward the foster child are clearly defined in a legal contract. Foster parents do not become the guardians of foster children; legal guardianship remains with the state agency.

Foster placements may last for a single day or several weeks; some continue for years. If the parents give up their rights permanently, or their rights to their child are severed by the court, the foster family may adopt the foster child or the child may be placed for adoption by strangers. Foster parenting is meant to be an in-between stage, while a permanent placement for the child is settled. As such, it is stressful and uncertain, but for many families very necessary.

Federal money supports most foster care programs, and federal law governs foster care policy. The Adoption Assistance and Child Welfare Reform Act of 1980 emphasizes two aims of foster care. One is to preserve the child's family, if at all possible. Children are placed in foster care only after other options have failed, and social service agencies work with the family to resolve its problems so that children can return to their homes. The second aim of the Child Welfare Reform Act is to support the so-called "permanency planning." This means that if a child must be removed from the home, the social service agency handling the case can decide quickly whether or not the child will ever be returned. If it seems likely that parents will not be able to care for their children again, their parental rights may be terminated so that the child is free to be adopted. This policy is articulated in this law in order to prevent children from living too long in an unstable and uncertain situation.

The goal of foster care is the care of the child within the child welfare system, but also is to place all appropriate and available services at the disposal of the parents so that they can create a safe, fit home environment for their children when they are reunited. Children in the child welfare system are also overseen by a multitude of agencies. The caseworker from the state or county social services agency oversees the child's placement and makes regular reports to the court. Others involved in the child's case are private service providers (including foster homes and group homes), welfare agencies, mental health counselors, substance abuse treatment centers (for the child or the parent), and Medicaid (federal medical insurance for seniors and children at risk).


In 1980, about 300,000 children in the United States spent some time in foster care placement. By 2001, there were nearly 800,000 children in foster care, with 540,000 children in the system at any given time. The majority of these children were the victims of abuse. The emergence of widespread homelessness, substance abuse (especially crack and methamphetamines), unemployment, increased incarceration rates, street violence, and HIV/AIDS have all impacted poor communities. Children from families with multiple problems flooded the child welfare system. Young children with physical handicaps, mental delays or mental illness, and complex medical conditions have become the fastest-growing foster care population.

The foster care population is quite young. About one-fourth of all children entering foster care for the first time are infants. Sixty percent of foster children are under four years old. Teenagers comprise one-third of the foster care population. Minority children comprise most of the foster care population, with the largest groups being African American and American Indian children.

Poor children are more likely to be in foster care than middle-class children because their families have fewer resources. Illness or loss of a job may be devastating to a poor family with no savings and no relatives who can afford to assist them. These children are also more likely to stay in foster care longer or to have been in foster care since infancy. Also, children of alcoholics or drug abusers are at high risk for neglect or abuse, and comprise 75 percent of all placements.

More than half (57 percent) of all children in foster care are returned to their original homes; however, reunification rates have declined in the 1990s and early twenty-first century. Children also spend more time in the system. The average length of stay for a child in foster care is 33 months. However, some spend a very short time in a foster home, and others are there for their entire childhoods, "aging out" at 18 when they become legal adults.

Instead of reunification, more children are being adopted from foster care. Most states doubled, and some tripled, the number of foster care adoptions since 1997. This steady increase is a response to the Adoption and Safe Families Act (ASFA) of 1997 that recommends termination of parental rights and encourages adoption if a child has been in foster care for 15 out of the previous 22 months. This can be waived by the court if the parents are making substantive progress or the caseworker believes that legal guardianship, but not adoption, is in the child's best interests.

Half of all children in foster care live with nonrelative foster caregivers; about one-fourth live with relatives, and this number is growing. ASFA also recognized kinship caregivers as legitimate placements. It was customary for many poor families to take in a child informally when the child's parents or legal guardians were incarcerated, in treatment, or had died, but ASFA allowed relatives to take care of a child legally and receive financial help, and also opened the doors to a number of agencies and services the relatives could not afford.

Common problems

In most cases, children placed in foster care have been subjected to some form of abuse or neglect, and being removed from familiar surroundings is, in itself, usually highly traumatic. Children in foster care may have nightmares , problems sleeping or eating, and may be depressed, angry, and confused. Many young children in foster care are unable to understand why they have been taken from their parents. Even if a child is in some sense relieved to be out of a home that was dangerous, the child may still miss the parents or legal guardians, and may imagine that there is something he or she must do to get back to them. There is evidence that children from abusive and neglectful homes start to feel better in foster care; however, separation is almost always difficult for children, regardless of the circumstances.

Half of all foster children spend as much as two years in foster care and are moved from placement to placement at least three times. This leads not only to uncertainty and lack of stability in the child's life, but some of these placements may be inappropriate for the child's specific circumstances. This often is due to the lack of qualified, licensed foster caregivers, but it can also occur as a result of inexperienced or overloaded caseworkers trying to get through their caseloads.

Foster care can be difficult for foster parents as well. A child who has been neglected or abused suffers psychological damage that may make him or her withdrawn, immature, aggressive, or otherwise difficult to reach. Children with severe medical and mental problems can tax caregivers. Foster placements sometimes fail because these surrogate parents simply cannot handle the demands of a troubled foster child.

Unfortunately, the number of foster caregivers has been declining since the mid-1980s as the demand for placements has increased. States have responded by licensing responsible adults who were not married (even divorced men and women) and reaching out to seniors and children's relatives. In some areas, single mothers make up a large proportion of foster parents.

In 2002, about 405,000 children were placed in court-appointed kinship care. Caseworkers placed almost 140,000 more in the care of relatives, without court intervention. Many of these kinship caregivers are grandparents or elderly aunts and uncles. Kinship caregivers offer family support and stability, and more frequent contact with parents or legal guardians, and siblings. They also are more apt to get children to talk to them about their problems, and the presence of relatives can help ease the trauma of separation from parents.

Nevertheless, kinship caregivers, especially grandparents, face a number of challenges. Most of the formal and informal kinship caregivers experience economic hardship as they take in one or more of their relative's children. Nearly two-thirds of these placements are with financially strapped families who may not have essentials such as a car seat, crib, or toys . They also may not have adequate medical insurance; however, Medicaid often will cover the foster child in a formal kinship arrangement. Grandparents may not know how to raise a child in today's world, with the amount of freedoms or lack of them that children experience today. They may not be able to help their foster children with homework. Many social service agencies offer counseling, homework help, and even home tutoring for both the child and caregiver.

One other problem inherent in the child welfare system is the teenager who "ages out," or turns 18 and moves out of foster care to live independently. Many teenagers mark time within the system, without adequate preparation for the transition to adulthood. Less than one-fourth of social service agencies provide employment services for teenagers. Only 17 percent provide employment and career assessments, and 16 percent provide job-training. One-fourth offer vocational training. Without help, these teenagers often never go on to college, do not find good jobs if they find jobs at all, and become prey to bad influences on the street. If they have children of their own, these offspring fall back into the child welfare system just as they did. Adequate training, counseling, and preparation can break this cycle.

In addition, children in all types of foster care face more challenges financially, emotionally, and developmentally. A study by the Child Welfare League of America in 2004 showed that children in foster care experienced more health and developmental problems than children who had similar economic circumstances but lived with their parents or legal guardians. Foster children also have more neglect, abuse, family dysfunction, poverty, and emotional problems. This may be a direct result of the reasons for their initial placement, but these conditions continue throughout foster care. Another reason for these results may be that foster children are given more frequent and thorough medical and psychological care than their counterparts.

Parental concerns

Other foster care placements are made by families who cannot afford medical or psychological services for their children. These children may have multiple disabilities or severe social or mental disorders that have depleted the family's financial and emotional resources. Convinced by social workers that this option is the only one available to them, they give up their parental rights in order to get their children into proper treatment. According to the U.S General Accounting Office, 12,700 children were placed into the child welfare system or the juvenile justice system to receive mental health services in 2001. Despite the noble reasons for placing these children in foster care, the parents' names are placed on state registries as child abusers, and they have to petition the court and prove their fitness to get their children returned to their homes.


Adoption The legal process that creates a parent and child relationship between two individuals who are not biologically related at birth.

Age out Become a legal adult at age 18 and move out of foster care.

Medicaid A program jointly funded by state and federal governments that reimburses hospitals and physicians for the care of individuals who cannot pay for their own medical expenses. These individuals may be in low-income households or may have chronic disabilities.

See also Child abuse.



Davies, Nancy Millichap. Foster Care. NY: Franklin Watts, 1994.


Bass, Sandra, et al. "Children, Families, and Foster Care: Analysis and Recommendations." The Future of Children. 14, no. 1 (Winter 2004): 430.

Hansen, Robin L., et al. "Comparing the Health Status of Low-Income Children in and out of Foster Care." Child Welfare 83, no. 4 (July-August 2004): 36781.

The David and Lucile Packard Foundation. "Children, Families, and Foster Care: Analysis." (Executive Summary) The Future of Children 14, no. 1 (Winter 2004): S1.


Foster Care Children. 507 North Sullivan Road Suite A-6. Spokane Valley, WA 99037. (509) 924-3175. Web site: <>.


Pew Commission on Children in Foster Care. Available online at: <>.

Janie Franz A. Woodward

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Foster Care

Foster Care

Foster care refers to the informal and formal custodial care of children outside of their own biological family home when their parents are unable, unwilling, or prohibited from caring for them. Historically, foster care provided homes to poor and parentless children and served to maintain order in a changing society. The origins of contemporary American foster care date back to the colonial-era practice of indentureship or "binding out." Following English tradition, families frequently placed their child with a master who taught the child a trade and provided basic sustenance in exchange for the child's labor. Poor children were often involuntarily bound out through public auction when a family was unable to provide for their care; exploitation was quite common in these circumstances. Indentureship declined in the late eighteenth and nineteenth centuries as reformers promoted institutional living and believed that its structured and contained life of the institution offered the solution to poverty and its accompanying social ills, including the plight of dependent and orphaned children.

The Formalization of Foster Care

The practice of foster care grew more formalized with the development of an anti-cruelty movement and the establishment of Societies for the Prevention of Cruelty to Children (SPCC) in the late nineteenth century. These agencies provided a feeder most commonly to institutions and to a lesser degree to family-based foster care. As a result the number of orphanages tripled between 1865 and 1890. Voluntary SPCC agents were often granted police power and removed children from their biological homes due to physical abuse or, more commonly, poverty-related neglect. Yet some nineteenth-century reformers questioned institutional practices. Most famously, Charles Loring Brace established the New York Children's Aid Society that sent urban orphaned, half-orphaned, and other poor children to reside with farm families. Espousing romanticized notions of countryside living and a belief that it was best to remove neglected and abused children from their families of origin, Brace's work constituted a response to the increased immigration, crime, and disease that characterized urban society. Brace, however, was not without his critics, particularly those who believed that the farm families exploited the children's labor and Catholic reformers who accused Brace of placing Catholic children in Protestant homes.

The Progressive Era witnessed a deepening concern with the plight of poor and orphaned children. The period's child-saving movement portrayed children as vulnerable beings in need of family protection, nurture, and affection and argued that a child was best cared for by its own biological parents. The child savers focused on a variety of child welfare initiatives, such as mothers' pensions, day nurseries, and public health reforms that they hoped would reduce the need for out-of-home care. Yet reformers such as Holmer Folks also recognized the continued need for custodial care and strongly advocated family-based foster care, which they viewed as far superior to institutional arrangements. Even Progressive-era child-caring institutions were refurbished to provide more of a family-like setting through "cottage" style housing although the majority of dependent children continued to be cared for in institutional settings in this period. These voluntary and largely sectarian foster care agencies often engaged in discriminatory practices. Historians of both the anti-cruelty and child-saving movements highlight the class and ethnic biases of middle-class Anglo Saxon reformers who intervened in the family life of poor immigrant families and often equated foreign cultural practices and poverty-ridden conditions with neglect. Moreover, the child welfare agencies typically denied African-American children foster care services or provided only a small number of homes on a segregated basis. As a result, early-twentieth-century African-American reformers established their own organizations, although these agencies often suffered from a lack of adequate funding. Members of the African-American community also fostered children on an informal basis, taking in children of friends, neighbors and relatives when assistance was needed. Informal fostering practices were also common in many immigrant communities.

Modern Foster Care

Concern with child welfare and foster care declined in the conservative 1920s and even the welfare state architects of the New Deal era paid little attention to foster care as they believed that larger anti-poverty efforts would reduce and ultimately eliminate the out-of-home placement of children. But the New Deal reformers were far from correct in their assessment. The years following World War II actually saw the development of the contemporary child welfare bureaucracy. The federal government provided an increasing amount of funds for the establishment and expansion of public child welfare agencies that, unlike the voluntary sectarian agencies, had to serve all children, regardless of race, ethnicity, or faith. The postwar period also witnessed the "rediscovery" of child abuse. Mid-century radiologists uncovered the phenomenon of multiple, repeat fractures in children resulting from parental abuse and in 1962 the Journal of the American Medical Association published a now famous paper entitled "The Battered Child Syndrome" by physician C. Henry Kempe and his associates. The article drew massive amounts of public attention and captured the imagination of a reform-minded America. Between 1963 and 1967 every state passed legislation mandating professionals to report suspected instances of child abuse and in 1972 Congress enacted the Child Abuse Prevention and Treatment Act that provided funds for a national center on child abuse and neglect. Not surprisingly, this legislation resulted in a huge increase in child abuse reports and ultimately a dramatic rise in the foster care population.

Disturbed by the growth in foster care, child welfare advocates of the 1970s uncovered the phenomenon of "foster care drift" in which children experienced multiple foster home placements. This phenomenon flew in the face of popular social scientific wisdom that stressed the importance of attachment and permanency for children's positive developmental outcomes. In response to this mounting critique, Congress passed the Child Welfare Act of 1980. The act attempted to reduce the foster care population by emphasizing family preservation and reunification programs and required state agencies to make "reasonable efforts" before removing a child from its home. It also institutionalized the previously informal practice of "kinship care" in which relatives serve as foster parents. While the act contributed to a temporary decline in the foster care population, from 1987 to 1992 the number of children in foster care grew from 280,000 to 460,000. While some suggest that the act suffered from inadequate funding, others partially attribute the rise in foster care to the development of an epidemic of drug use that ravaged low-income, inner-city America during the 1980s. At the same time, family preservation efforts came under fire as some research showed that intensive social work programs did little to prevent child removal and a series of highly publicized child abuse cases described how children were allowed to remain or return to the homes of their biological parents where they ultimately met their deaths. Other critics were especially concerned about the growing overrepresentation of African-American children in the foster care population, which some attributed to institutionalized racism within the child welfare system.

The backlash against family preservation along with ongoing concern regarding the number of children in foster care culminated in the passage of the federal Adoption and Safe Families Act (ASFA) of 1997. ASFA sought to reduce the foster care population and promotes permanency for children by stressing adoption over family preservation efforts, although some money was set aside for family preservation. The act sped up the time line toward termination of parental rights, allowed for "concurrent planning" in which child welfare workers simultaneously prepare for family reunification and adoption, and provided states with financial incentives for adoption. Adoption advocates argue that with increased assistance safe and loving adoptive homes can increasingly be found for foster children who were previously considered "hard to place"such as those experiencing physical or psychiatric disabilities or children of color who historically have experienced low adoption rates.

Ongoing Critiques

Critics of the contemporary child welfare system argue that it is not foster care in and of itself that produces poor outcomes for children but rather a dysfunctional, underfunded child welfare bureaucracy run by poorly trained and over-whelmed staff. The Child Welfare League of America observed that by 2002 caseworkers in some states had up to 55 children on their caseloads, while the League recommended a caseload of no more than 15 children. Others maintain that the inadequacy of the child welfare system stems from its inability to address the primary issue contributing to child neglect, abuse, and removal: poverty. Indeed, the overwhelming majority of children in foster care are born into poverty and some studies show that the primary predictor of child removal is not the severity of abuse but the level of the family's income. Critics noted that in the early twenty-first century the United States had the highest rate of child poverty of any industrialized Western nation and argued the income and social supports more typical of Western European nations, such as family allowances, government-supported day care, family leave policies, more generous benefits for single mothers and their children, would reduce the number of American children in foster care.

See also: Placing Out; Social Welfare.


Ashby, LeRoy. 1997. Endangered Children: Dependency, Neglect, and Abuse in American History. New York: Twayne.

Billingsley, Andrew and Jeanne Giovannoni. 1972. Children of the Storm: Black Children and American Child Welfare. New York: Harcourt Brace Jovanovich.

Duncan, Lindsey. 1994. The Welfare of Children. New York: Oxford University Press.

Gordon, Linda 1988. Heroes of Their Own Lives: The Politics and History of Family Violence, Boston, 18801960. New York: Viking.

Mason, Mary Ann. 1994. From Father's Property to Children's Rights: The History of Child Custody in the United States. New York: Columbia University Press.

Nelson, Barbara. 1984. Making an Issue of Child Abuse: Political Agenda Setting for Social Problems. Chicago: The University of Chicago Press.

Platt, Anthony. 1969. The Child Savers: The Invention of Delinquency. Chicago: University of Chicago Press.

Roberts, Dorothy. 2002. Shattered Bonds: The Color of Child Welfare. New York: BasicBooks.

Tiffin, Susan 1982. In Whose Best Interest? Child Welfare Reform in the Progressive Era. Westport, CT: Greenwood Press.

Laura Curran

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Foster Care


FOSTER CARE. Approximately three million reports of child maltreatment (physical abuse, sexual abuse, neglect, and abandonment) come to the attention of public child welfare agencies in the United States every year. Hundreds of thousands of these reports are considered serious enough to be investigated, and about one-third are substantiated or proven. Of the cases that are substantiated, approximately 175,000 to 200,000 are placed into foster care.

Health care professionals refer to foster care as the temporary out-of-home placement for abused and neglected children. Typically, such placements are made in the homes of families specifically recruited and trained to care for troubled children or, increasingly, in the homes of relatives. However, about 20 percent of these children are placed in group homes or residential treatment centers. The placements are supposed to be for as short a period of time as possible, with the primary goal being to return the child to his or her birth parent or parents as soon as it is safe to do so. If the child cannot be returned home within a reasonable period of time, other permanent plans must be made for him or her, particularly adoption.

In the United States, foster care programs are usually administered and delivered by state and local public child welfare agencies. However, public child welfare agencies often contract with private not-for-profit and, to a much lesser extent, private for-profit organizations to provide foster care services.

Although public child welfare agencies are creatures of state governments, the federal government has played an increasingly larger role in child welfare. For example, federal laws have been enacted that provide fiscal incentives to states, in order to encourage them to adopt certain child welfare policies and practices. Also, the federal government has made available increasing amounts of funding, usually on a matching basis, for foster care and adoptions services. In addition, the federal government collects, archives, and disseminates child welfare data and information and provides a modest amount of funding for research.

There were two major pieces of federal child welfare legislation enacted in the late twentieth century. The first was the Adoptions Assistance and Child Welfare Act of 1980, more popularly known as P.L. 96-272. This legislation grew out of more than six years of congressional hearings into the problems confronting the child welfare system in the United States. The act placed greater emphasis on strengthening and preserving families and, in fact, placed as much emphasis on this new policy thrust as it did on protecting and caring for abused and neglected children. Consistent with this, one of the major priorities of the legislation was to increase services to prevent the out-of-home placement of children and to reduce the numbers of children being placed into foster care. Lawmakers also hoped that the act would result in shorter lengths of stay in placement, the elimination of foster care "drift" or the "bouncing" of children from one placement to another, improved training and supervision of foster parents, improved training for child welfare workers, and the delivery of more effective services to children in placement.

The law mandated that individualized treatment plans be developed for each child placed into foster care. It required that each child in placement had to have his or her case reviewed every six months to examine the status of the case and to determine whether the placement needed to be continued or if other permanent plans needed to be made.

Unfortunately, despite the hopes and expectations of reformers, the law had relatively little impact on the child welfare system. Beginning in the mid-1980s, the numbers and rates of children placed into foster care increased dramatically. This trend continued well into the 1990s. In fact, the best available data suggests the foster care population more than doubled between 1985 and 1999. Although significant amounts of money were spent on placement prevention services, there is virtually no credible scientific evidence that they had the desired impact. Even more disturbing is the fact that many class action lawsuits were filed against state and local public child welfare systems for abusive, unprofessional, and unconstitutional practices after P.L. 96-272 was passed. This statistic suggests that many public child welfare systems may have deteriorated during this period when policymakers and reformers expected them to improve.

In 1997 Congress passed the Adoptions and Safe Families Act, or ASFA. In sharp contrast to P.L. 96-272, this legislation places more emphasis on protecting children and makes it easier to remove them from dangerous home environments. The legislation calls for placing more of the burden on abusive and neglectful parents to demonstrate that they can properly care for their children before they will be returned to them. It also reduces the amount of time children have to stay in foster care from eighteen months to twelve months before permanent plans have to be made for them.

By 2002 most child welfare officials felt it was too soon to make any definitive statements about the impact of ASFA. Preliminary data suggest that increasing numbers of children are being adopted, although the numbers may be leveling off. Also, there are signs that the size of the foster care population may be stabilizing, or even declining. However, the length of stay in foster care for children awaiting adoption continues to average three years. For these children it can be said that the state has virtually become their parent, even if by default.


Schwartz, Ira M., and Gideon Fishman. Kids Raised by the Government. Westport, Conn.: Praeger, 1999.

United States Department of Health and Human Services. The AFCARS Report. Washington, D.C.: Administration for Children and Families, 2000.

Ira M.Schwartz

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community care

community care An imprecise and much abused concept embracing a diverse set of policies for dependent persons—particularly those chronically dependent by virtue of age, mental illness, or mental or physical handicap—which involve, in some way or another, looking after them in the community. In its most general sense, the community is here merely negatively defined as ‘not the institution’; that is, not the large-scale, long-stay institution, such as the asylum or workhouse. Inherent in the concept is, therefore, a contrast between old institutional policies that encouraged the separation of people from the community (ordinary everyday life), and new policies according to which individuals are cared for and integrated into community life as far as possible. This basic opposition is associated with contrasting stereotypes: the vast, impersonal, isolated, impoverishing, harsh, and bureaucratic institution, on the one hand, and on the other the friendly, supportive, enriching, and caring (with its connotations of love) community. It is this contrasting imagery that gives the notion of community care such strong symbolic power, accounts for the ready acceptance of policies put forward in its name, and (regrettably) distracts attention from any precise examination of the care, if any, that is provided.

The actual character of community-care provisions varies enormously and changes over time. Only detailed knowledge of service arrangements and policies allows us to determine their exact nature. In its early usage in the 1930s, community care referred to the boarding out (fostering) of those identified as mentally subnormal. Here and elsewhere the model was of publicly funded and administered alternatives to institutional care. After the Second World War, when community care became a very widely accepted policy objective, it still referred to publicly provided services, including ‘half-way’ houses and small residential units for the chronically dependent, or units in general hospitals for those with acute problems. Not surprisingly, the main obstacle to policy implementation was the capital investment required, in a context of low capital expenditure on state welfare services; studies showed that in Britain the implementation of community-care policies was slow.

In the United States community care spread more rapidly. Although some new state-funded services were established, such as Community Mental Health Centres (which in practice primarily dealt with acute problems), many people with chronic problems were discharged into private facilities such as nursing homes and boarding houses. The introduction of community care consequently went hand in hand with the privatization of care—a trend exacerbated in the 1970s by the cutbacks in federal support for facilities like CMHCs.

A similar pattern emerged in Britain from the mid-1970s, prompted by the state's fiscal crisis, and compounded by public expenditure cuts. Community care increasingly meant private care, whether provided by commercial or charitable groups, or family and friends—a transformation which ensured that public expenditure pressures accelerated rather than curtailed policy implementation. It also ensured that, with the run-down in public services, many individuals faced neglect and marginalization (rather than enjoying care and support) in the community, or else experienced a process of ‘trans-institutionalization’, discharged from one (large-scale) institution only to end up in another—albeit smaller. The marked failures of community care in Europe and the United States, as well as its somewhat limited successes, are now well documented.

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foster care

foster care, generally, care of children on a full-time, temporary basis by persons other than their own parents. Also known as boarding-home care, foster care is intended to offer a supportive family environment to children whose natural parents cannot raise them because of the parents' physical or mental illness, the child's behavioral difficulties, or problems within the family environment, e.g., child abuse, alcoholism, extreme poverty, or crime. Such children are usually wards of the state. They may be placed by a state-approved agency in group homes, institutions (such as residential treatment centers), or with families who receive some payment toward care. The child's parents may retain their parental rights, and the child may ultimately return home. Under permanent foster care the agency has guardianship; the child may then be available for adoption by the foster parents or others. Foster care can also provide a supervised setting for adults with mental or emotional disabilities who cannot care adequately for themselves. The concept of foster care has been extended in recent years to include care for elderly persons, on a fee basis, in the homes of people who are not family members.

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